Ciprofloxacin Ophthalmic: MedlinePlus Drug Information

pronounced as (sip roe flox’ a sin)

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Ciprofloxacin ophthalmic solution is used to treat bacterial infections of the eye including conjunctivitis (pinkeye; infection of the membrane that covers the outside of the eyeball and the inside of the eyelid) and corneal ulcers (infection and loss of tissue in the clear front part of the eye). Ciprofloxacin ophthalmic ointment is used to treat conjunctivitis. Ciprofloxacin is in a class of antibiotics called fluoroquinolones. It works by killing the bacteria that cause infection.

Ophthalmic ciprofloxacin comes as a solution (liquid) and an ointment to apply to the eyes. Ciprofloxacin ophthalmic solution is usually used often, between once every 15 minutes to once every 4 hours while awake for 7 to 14 days or longer. Ciprofloxacin ophthalmic ointment is usually applied 3 times a day for 2 days and then twice a day for 5 days. Use ophthalmic ciprofloxacin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ophthalmic ciprofloxacin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.

You should expect your symptoms to improve during your treatment. Call your doctor if your symptoms do not go away or get worse, or if you develop other problems with your eyes during your treatment.

Use ophthalmic ciprofloxacin until you finish the prescription, even if you feel better. If you stop using ophthalmic ciprofloxacin too soon, your infection may not be completely cured and the bacteria may become resistant to antibiotics.

To instill the eye drops, follow these steps:

1. Wash your hands thoroughly with soap and water.
2. Check the dropper tip to make sure that it is not chipped or cracked.
3. Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
4. While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
5. Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
6. Brace the remaining fingers of that hand against your face.
7. While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
8. Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
9. Place a finger on the tear duct and apply gentle pressure.
10. Wipe any excess liquid from your face with a tissue.
11. If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
12. Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
13. Wash your hands to remove any medication.

To apply the eye ointment, follow these instructions:

1. Wash your hands thoroughly with soap and water.
2. Avoid touching the tip of the tube against your eye or anything else; the tube tip must be kept clean.
3. Holding the tube between your thumb and forefinger, place it as near to your eyelid as possible without touching it.
4. Brace the remaining fingers of that hand against your face.
5. Tilt your head backward slightly.
6. With your index finger, pull the lower eyelid down to form a pocket.
7. Squeeze a 1/2-inch (1.25-centimeter) ribbon of ointment into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
8. Blink your eye slowly; then gently close your eye for 1 to 2 minutes.
9. With a tissue, wipe any excess ointment from the eyelids and lashes. With another clean tissue, wipe the tip of the tube clean.
10. Replace and tighten the cap right away.
11. Wash your hands to remove any medication.

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

Before using ophthalmic ciprofloxacin,

• tell your doctor and pharmacist if you are allergic to ciprofloxacin (Cipro, Ciloxan), other quinolone antibiotics such as cinoxacin (Cinobac) (not available in the United States), enoxacin (Penetrex) (not available in the United States), gatifloxacin (Tequin, Zymar), levofloxacin (Levaquin, Quixin, Iquix), lomefloxacin (Maxaquin), moxifloxacin (Avelox, Vigamox), nalidixic acid (NegGram) (not available in the United States), norfloxacin (Noroxin), ofloxacin (Floxin, Ocuflox), and sparfloxacin (Zagam), any other medications, or benzalkonium chloride.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking. Be sure to mention any of the following: anticoagulants (‘blood thinners’) such as warfarin (Coumadin), cyclosporine (Neoral, Sandimmune), and theophylline (Theo-Dur). Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor if you have or have ever had any medical condition.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while using ophthalmic ciprofloxacin, call your doctor.
• you should know that your vision may be blurred during your treatment with ciprofloxacin ophthalmic ointment. Avoid rubbing your eyes even if your vision is blurred. Do not drive a car or operate machinery if you are unable to see clearly.
• tell your doctor if you wear contact lenses. You should not wear contact lenses while you have symptoms of bacterial conjunctivitis or while you are applying eye drops or ointment.
• you should know that bacterial conjunctivitis spreads easily. Wash your hands often, especially after you touch your eyes. When your infection goes away, you should wash or replace any eye makeup, contact lenses, or other objects that touched your infected eye(s).

Talk to your doctor about drinking coffee or other beverages containing caffeine while you are taking this medication.

Place the missed dose in your eye(s) as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not use a double dose to make up for a missed one.

Ophthalmic ciprofloxacin may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• burning, red, itchy, crusty, or irritated eyes
• eye pain
• feeling that something is in your eye
• unpleasant taste

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• rash
• hives
• itching
• tingling
• swelling of the face, throat, tongue, lips, eyes, hands, feet, ankles, or lower legs
• difficulty breathing or swallowing
• hoarseness

Ophthalmic ciprofloxacin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom).

It is important to keep all medication out of sight and reach of children as many containers (such as weekly pill minders and those for eye drops, creams, patches, and inhalers) are not child-resistant and young children can open them easily. To protect young children from poisoning, always lock safety caps and immediately place the medication in a safe location – one that is up and away and out of their sight and reach. http://www.upandaway.org

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

If you instill too many drops of the ophthalmic solution in your eye, wash your eye with plenty of warm tap water.

• Ciloxan^®

Last Revised – 02/15/2018

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Side effects of ciprofloxacin – NHS

Like all medicines, ciprofloxacin can cause side effects although not everyone gets them.

Common side effects

These common side effects of ciprofloxacin happen in more than 1 in 100 people. There are things you can do to help cope with them:

Feeling sick (nausea)

If you feel sick after taking the tablets or liquid, stick to simple meals and do not eat rich or spicy food while you’re taking this medicine. It might help to take ciprofloxacin after you have had a meal or snack.

Diarrhoea

If you get diarrhoea after taking the tablets or liquid, drink lots of fluids, such as water or squash, to avoid dehydration. Signs of dehydration include peeing less than usual or having dark strong-smelling pee.

Do not take any other medicines to treat diarrhoea without speaking to a pharmacist or doctor.

If you take contraceptive pills and you have severe diarrhoea for more than 24 hours, your contraception may not protect you from pregnancy. Check the pill packet for advice.

Redness or discomfort in the eye

If you feel a stinging, burning or gritty feeling in your eye after using the eye drops, this should go away on its own. Do not drive, ride a bike or operate heavy machinery until your eyes feel comfortable again and your vision is clear.

Bad taste in the mouth

If you get a bad taste in your mouth after using ciprofloxacin eye drops, it does not usually last long. Drink some water or juice, or chew some sugar-free gum.

White specks on the surface of your eye

If you get white specks on the surface of your eye after using the eye drops, keep using your ciprofloxacin but tell your doctor if it bothers you or does not go away.

Speak to a doctor or pharmacist if this advice on how to cope does not help and a side effect is still bothering you or lasts more than a few days.

Serious side effects

Very few people taking or using ciprofloxacin have serious side effects.

They are less likely to happen with the eye drops or ear drops.

These serious side effects can happen in less than 1 in 100 people. Stop taking ciprofloxacin and call your doctor or call 111 now if you have:

• muscle weakness, pain or swelling in your joints or tendons. This often begins in the ankle or calf, but could also be in your shoulder, arms or legs. It can happen in the first 2 days of taking ciprofloxacin or even several months after stopping. It is more common in children
• pain or abnormal sensations (such as pins and needles that do not go away, tingling, tickling, numbness or burning) or weakness in your body, especially in your legs or arms
• severe tiredness, feel anxious or very low in mood, or have difficulty sleeping or remembering things
• ringing in your ears (tinnitus), loss of taste, are seeing double, or have any other changes in your sight, smell, taste or hearing
• diarrhoea (perhaps with muscle cramps) that contains blood or mucus – if you have severe diarrhoea without blood or mucus for more than 4 days, also speak to a doctor
• a faster or irregular heartbeat, or heartbeats that suddenly become more noticeable (palpitations)
• sudden breathlessness, especially when you’re lying down
• swollen ankles, feet or stomach

Immediate action required: Call 999 if:

• you have sudden, severe pain in your stomach, chest or back
• you have seizures or fits

Serious allergic reaction

In rare cases, it’s possible to have a serious allergic reaction (anaphylaxis) to ciprofloxacin.

Immediate action required: Call 999 now if:

• your lips, mouth, throat or tongue suddenly become swollen
• you’re breathing very fast or struggling to breathe (you may become very wheezy or feel like you’re choking or gasping for air)
• your throat feels tight or you’re struggling to swallow
• your skin, tongue or lips turn blue, grey or pale (if you have black or brown skin, this may be easier to see on the palms of your hands or soles of your feet)
• you suddenly become very confused, drowsy or dizzy
• someone faints and cannot be woken up
• a child is limp, floppy or not responding like they normally do (their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head or focus on your face)

You or the person who’s unwell may also have a rash that’s swollen, raised, itchy, blistered or peeling.

These can be signs of a serious allergic reaction and may need immediate treatment in hospital.

Other side effects

These are not all the side effects of ciprofloxacin. For a full list, see the leaflet inside your medicine packet.

Find out more about muscle weakness, pain or swelling after taking ciprofloxacin on the GOV.UK website

Information:

You can report any suspected side effect using the Yellow Card safety scheme.

Visit Yellow Card for further information.

Page last reviewed: 13 December 2022

Next review due: 13 December 2025

The use of ciprofloxacin in the treatment of children with cancer

Antibiotic

Trademarks:

Cipro®

Other names:

Ciprofloxacin Hydrochloride

Often used for:

Treatment and prevention of infections

Ciprofloxacin is an antibiotic; its action is aimed at the destruction of bacteria that cause infections.

Ciprofloxacin is available in various formulations. Follow dosage instructions carefully.

Oral tablets

Oral liquid form

Administered intravenously (through a drip) in liquid form

• Rash
• Nausea and vomiting
• Diarrhea
• Headache
• Sun sensitivity
• Abdominal pain
• Heartburn
• Fatigue or drowsiness
• Vaginal itching and/or vaginal discharge

The listed side effects are not observed in all patients who are prescribed ciprofloxacin. The most common side effects are highlighted in bold, but others are not excluded. Report all possible side effects to your doctor or pharmacist.

• Diseases of the joints, muscles or tendons
• Peripheral neuropathy

Be sure to discuss these and other recommendations with your doctor or pharmacist.

• Tell your doctor if you have severe diarrhea while taking this drug.
• It is important to drink plenty of fluids during therapy with ciprofloxacin. It is necessary to drink the amount of liquid recommended by the doctor.
• When prescribing ciprofloxacin, antacids should be avoided unless this type of drug has been prescribed by your doctor.
• Patients should protect their skin from the sun while on therapy with this drug.
• Pregnant or breastfeeding patients should notify their physician.
• The course of taking the drug must be completed completely in accordance with the recommendations of the attending physician or pharmacist.

Taking ciprofloxacin at home:

• The drug should be taken at the same time every day.
• Ciprofloxacin may be taken with or without food. If the drug causes stomach upset, it must be taken with food.
• Recommended to take with a full glass of water.
• Do not take ciprofloxacin with dairy products or foods rich in calcium (other than a full meal).
• Limit caffeine intake when taking this drug.
• Tablets should be swallowed whole. It is not allowed to crush, chew or break the medicine before taking it.
• Liquid Ciprofloxacin: Shake well before use, measure using the measuring device provided.
• Do not give liquid ciprofloxacin via an enteral feeding tube. The drug should be taken in the form of tablets in accordance with the recommendations of the attending physician or pharmacist.
• Ciprofloxacin (when taken orally) should be stored at room temperature.
• Take your dose as soon as possible if you miss it. Do not do this only if there is little time left until the next appointment. In no case do not double the dose at the next dose! Do not take more than one extended-release tablet per day.
• Do not use an expired drug.
• Follow instructions for safe storage and disposal of the drug.

Learn more about ciprofloxacin

antibiotic ciprofloxacin instructions for use (ciprofloxacin 500mg)

Ciprofloxacin is a broad spectrum antibiotic used to treat a wide range of bacterial infections such as UTIs, infections of the eyes, ears, lungs, joints, heart, skin, stomach and intestines . It belongs to a group of antibiotics called quinolones.

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What is ciprofloxacin 500 mg used for?

Ciprofloxacin is a fluoroquinolone antibiotic whose chemical structure makes it effective against both Gram-positive and Gram-negative bacteria. It is and has been one of the most widely used antibiotics worldwide. Its use and misuse has contributed to the development of drug-resistant strains of bacteria, which, combined with the risk of serious side effects caused by this drug, has made the use of ciprofloxacin as a first-line treatment no longer recommended in many infections.

Ciprofloxacin may be indicated for the treatment of:

• Gram-negative bacteria in the lower respiratory tract
• Pneumonia
• Urinary tract infections (UTIs)
• orchitis and pelvic inflammatory disease (PID) ) caused by Neisseria Gonorrhoeae
• Gastrointestinal tract (GIT) infections
• Bone and joint infections
• Gram-negative sinusitis
• Gram-negative skin infections
• Prophylaxis of meningitis after infection with Neisseria Meningitidis
• Inhalation for anthrax

aerobic pathogens, bacteria resistant to fluoroquinolones, or viral infections, as well as for the treatment of children, pregnant or breastfeeding women without the advice of a specialist.

Dosages and formulations of ciprofloxacin

Ciprofloxacin is a prescription-only drug and is available in both brand name and generic form. It is available in various forms and formulations such as ear drops, eye drops, eye ointment, tablets, extended release tablets, suspension, and combination formulations with other drugs. The most common of these are:

• Ciprofloxacin 250 mg tablets
• Ciprofloxacin 500 mg tablets
• Ciprofloxacin 750 mg tablets
• Ciprofloxacin 250 mg/5 ml liquid
• Ciprofloxacin 0.3% i.v. ointment 0.3%
• Ciprofloxacin otic solution 0, 3% (eardrops)

Ciprofloxacin is widely known under the trade names Ciproxin (tablets), Cyprobay (tablets), Ciflox (tablets), Cipro (tablets), Proquin XR (extended release tablets), Ciloxan (eye drops and eye ointment) and Cetraxal (ear drops).

How do I take the antibiotic ciprofloxacin?

Ciprofloxacin should be taken at the same time each day and at regular intervals as directed by your doctor. Tablets should not be chewed, they should be swallowed with water or other liquid.

Posology (composition, dose and duration of treatment) is determined by the doctor depending on the disease you are treating, your individual characteristics and response to treatment. Depending on the indication, it varies from 250 mg as a single dose to 500 mg twice a day for 3-7-14-21-90 days.

May be taken with or without food, but should not be taken with dairy products or drinks, or calcium-fortified foods such as some orange juices (see precautions below). If you take the drug without food, it is absorbed more quickly, but this may cause gastrointestinal side effects.

Ciprofloxacin 500 mg for the treatment of UTI – acute cystitis

Ciprofloxacin may be indicated for the treatment of acute uncomplicated UTI (urinary tract infection).

In these cases, ciprofloxacin should be taken as directed by a physician, usually as follows:

• Ciprofloxacin 250 mg twice daily for 3 days
• Ciprofloxacin 500 mg XR (extended release) once daily for 3 days .

For complicated UTIs, ciprofloxacin is given at a higher dosage for a longer period of time, eg 500 mg twice a day for 7-14 days.

Ciprofloxacin should only be used for uncomplicated UTIs if the patient has no other treatment options, as the risk of potential serious side effects outweighs the benefit.

Ciprofloxacin against biological warfare agents: anthrax and plague

Ciprofloxacin is stockpiled by some government agencies to prepare for bioweapons emergencies. Ciprofloxacin can be used to treat anthrax (Bacillus anthracis), pneumonic plague (Yersinia pestis), and tularemia (Francisella Tularensis).

Ciprofloxacin for gonorrhea, chlamydia and syphilis (STDs)

Sexually transmitted bacterial infections are on the rise. In the United States, the number of STD cases has been steadily increasing every year since 2014, according to the CDC. Due to the high incidence of gonorrhea, chlamydia, and syphilis worldwide, and the use and abuse of antibiotic therapy, most bacteria are now resistant to one or more treatment options. It is imperative not to try to cure any of these diseases through self-administration of antibiotic therapy: antibiotic resistance varies by geographic location, so treatment protocols also differ. While ciprofloxacin was previously used to treat gonorrhea, this is now rare: in some regions of the world, gonorrhea resistance to quinolones is almost 100%; Ciprofloxacin 500mg has also been used in some cases to treat chlamydia but has never been considered a first-line treatment for chlamydial infection and its use in this infection is limited to a small number of cases. Ciprofloxacin has never been used and is not effective against syphilis and Treponema Pallidum, for which only penicillins are indicated.

Ciprofloxacin during pregnancy and lactation

Although evidence suggests the safety of ciprofloxacin during pregnancy, it is generally avoided as a precautionary measure due to the potential risk of cartilage, tendon and joint damage to the developing fetus. Ciprofloxacin is also excreted in breast milk, therefore, due to the potential risk of joint damage in the baby, it should not be used in breastfeeding women unless otherwise directed by your healthcare professional.

Ciprofloxacin 500 mg for the prevention of meningitis

People who have been in contact with patients infected with meningitis caused by the bacterium Neisseria Meningitidis may be advised to take post-exposure antibiotic prophylaxis with ciprofloxacin 500 mg as a single dose.

How quickly does ciprofloxacin work?

Ciprofloxacin begins to work within a few hours of ingestion. After 36-48 hours, you should already notice some improvement or even a clear disappearance of all symptoms within 72 hours: do not stop treatment and complete the entire course of the antibiotic as directed by the doctor; if you don’t, the infection may return, and this time it may become resistant to ciprofloxacin treatment.

Precautions while taking ciprofloxacin

Before taking ciprofloxacin 500 mg, you must tell your doctor and/or pharmacist if you have ever had an allergic reaction after taking it, or after taking other quinolone antibiotics such as levofloxacin, or other medicines, or if you are allergic to any of the other ingredients in the medicines.

Before taking ciprofloxacin 500 mg, you should also tell your doctor and/or pharmacist about all other prescription and over-the-counter drugs, supplements, vitamins, herbs you are taking due to possible drug interactions.

Calcium-rich foods, calcium supplements and antacids containing calcium, as well as other minerals such as magnesium, aluminium, iron and zinc, may reduce the absorption of ciprofloxacin and reduce its effectiveness. It is recommended that you take ciprofloxacin 2-4 hours before or 4-6 hours after taking any calcium-rich supplements, medications, or foods. Discuss this with your healthcare provider.

Drink plenty of water while taking ciprofloxacin to prevent some of the unwanted effects caused by the antibiotic.

Alcohol does not render ciprofloxacin ineffective, but may increase side effects such as dizziness. It is best to always eliminate or at least limit your intake of alcohol. Marijuana can also cause dizziness while taking this medication, check with your doctor if you use marijuana.

Always complete a course of antibiotics. Even if you feel better, it is very important to follow the prescribed therapy; if you don’t, the infection may return and you may develop a difficult-to-treat antibiotic-resistant bacterial infection.

Ciprofloxacin may make your skin more sensitive to UV radiation. Avoid tanning beds, always use sunscreen outdoors, and limit your time in the sun.

Never take antibiotics unless your doctor tells you to. If you have some ciprofloxacin left, don’t take it just because you think the symptoms you’re experiencing now are the same ones you’ve been treated with in the past. Let your healthcare provider evaluate your symptoms and prescribe appropriate treatment to avoid the risk of developing antibiotic-resistant, hard-to-treat bacterial infections.

Warnings and side effects

Like all medicines, ciprofloxacin can cause side effects such as nausea, vomiting, diarrhea, stomach pain, drowsiness and tiredness. Other more rare and serious symptoms that may occur are:

• Rash
• Fever
• Tendonitis or tendon rupture
• Swelling (face, tongue, throat, arms, legs, …)
• Peeling or blisters on skin
• Difficulty breathing or swallowing

If you experience serious side effects, call your doctor or seek emergency medical attention.

How to store ciprofloxacin?

Ciprofloxacin should be kept in the original carton and container in which it was supplied; The container must be tightly closed and kept out of the reach of children. Tablets should be stored at room temperature, away from moisture and heat. The suspension form of this medicine should be stored in the refrigerator for no more than 14 days and then discarded. Do not freeze ciprofloxacin suspension.

What if I miss a ciprofloxacin 500 mg tablet?

As a general rule, if you miss a dose, you should take a tablet as soon as you remember. If it is close to your next dose, skip the missed dose and continue taking your medicine as per your schedule. Do not take a double dose to make up for a missed one. For more information, see the patient information leaflet or ask your family doctor or pharmacist.

Important Disclaimer: This is a summary of ciprofloxacin and does NOT contain all the information available about this product.